What systemic factors contribute to collaboration between primary care and public health sectors? An interpretive descriptive study

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dc.contributor.authorWong, Sabrina T.
dc.contributor.authorMacDonald, Marjorie
dc.contributor.authorMartin-Misener, Ruth
dc.contributor.authorMeagher-Stewart, Donna
dc.contributor.authorO'Mara, Linda
dc.contributor.authorValaitis, Ruta K.
dc.date.accessioned2019-06-10T15:57:04Z
dc.date.available2019-06-10T15:57:04Z
dc.date.copyright2017en_US
dc.date.issued2017
dc.description.abstractBackground Purposefully building stronger collaborations between primary care (PC) and public health (PH) is one approach to strengthening primary health care. The purpose of this paper is to report: 1) what systemic factors influence collaborations between PC and PH; and 2) how systemic factors interact and could influence collaboration. Methods This interpretive descriptive study used purposive and snowball sampling to recruit and conduct interviews with PC and PH key informants in British Columbia (n = 20), Ontario (n = 19), and Nova Scotia (n = 21), Canada. Other participants (n = 14) were knowledgeable about collaborations and were located in various Canadian provinces or working at a national level. Data were organized into codes and thematic analysis was completed using NVivo. The frequency of “sources” (individual transcripts), “references” (quotes), and matrix queries were used to identify potential relationships between factors. Results We conducted a total of 70 in-depth interviews with 74 participants working in either PC (n = 33) or PH (n = 32), both PC and PH (n = 7), or neither sector (n = 2). Participant roles included direct service providers (n = 17), senior program managers (n = 14), executive officers (n = 11), and middle managers (n = 10). Seven systemic factors for collaboration were identified: 1) health service structures that promote collaboration; 2) funding models and financial incentives supporting collaboration; 3) governmental and regulatory policies and mandates for collaboration; 4) power relations; 5) harmonized information and communication infrastructure; 6) targeted professional education; and 7) formal systems leaders as collaborative champions. Conclusions Most themes were discussed with equal frequency between PC and PH. An assessment of the system level context (i.e., provincial and regional organization and funding of PC and PH, history of government in successful implementation of health care reform, etc) along with these seven system level factors could assist other jurisdictions in moving towards increased PC and PH collaboration. There was some variation in the importance of the themes across provinces. British Columbia participants more frequently discussed system structures that could promote collaboration, power relations, harmonized information and communication structures, formal systems leaders as collaboration champions and targeted professional education. Ontario participants most frequently discussed governmental and regulatory policies and mandates for collaboration.en_US
dc.description.reviewstatusRevieweden_US
dc.description.scholarlevelFacultyen_US
dc.description.sponsorshipThis study was funded by the Canadian Health Services Research Foundation (# RC2-1604-06) in partnership with: the Michael Smith Foundation for Health Research; Health Services & Policy Research Support Network; McMaster University; Public Health Agency of Canada; Canadian Public Health Association; Central zone (formerly Capital Health Authority), Nova Scotia; Hamilton Niagara, Haldimand Brant Local Health Integration Network; Huron County Health Unit; Somerset West Community Health Centre; Registered Nurses Association of Ontario (RNAO), and Victorian Order of Nurses Canada. M. MacDonald was supported by a CIHR/PHAC Applied Public Health Chair Research award (Grant No. 92365) during the time this study was conducted.en_US
dc.identifier.citationWong, S. T.; MacDonald, M.; Martin-Misener, R.; Meagher-Stewart, D.; O’Mara, L.; & Valaitis, R. K. (2017). What systemic factors contribute to collaboration between primary care and public health sectors? An interpretive descriptive study. BMC Health Services Research, 17, 796. DOI: 10.1186/s12913-017-2730-1en_US
dc.identifier.urihttps://doi.org/10.1186/s12913-017-2730-1
dc.identifier.urihttp://hdl.handle.net/1828/10915
dc.language.isoenen_US
dc.publisherBMC Health Services Researchen_US
dc.subjectprimary health care
dc.subjectCanada
dc.subjecthealth system
dc.subjecthealth services delivery
dc.subjectqualitative
dc.subject.departmentSchool of Nursing
dc.titleWhat systemic factors contribute to collaboration between primary care and public health sectors? An interpretive descriptive studyen_US
dc.typeArticleen_US

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